Your fund pays premiums the state would pay.

Many retirees on your Part B reimbursement qualify for New York’s Medicare Savings Program, which pays the whole premium. Most never apply. Mycelium enrolls them by text with their yes, renews it every year, and takes a fifth of what you stop paying.

Get your numberSee the numbers

Four in ten
never apply.

New York’s Medicare Savings Program pays the whole Part B premium for a retiree with up to about $2,494 a month before deductions, or $3,375 for a couple, and savings don’t count. About 4 in 10 people who qualify aren’t enrolled. When one of them is on your reimbursement, your fund pays a premium the state would cover.

We sign a HIPAA business associate agreement before we see a file. The fund sees totals and the reimbursements to stop, timed to when Social Security stops the deduction; it never sees a retiree’s thread.

Today · 10:12 AM
Got the letter from the fund about Part B. Is this real?
It’s real. New York pays the whole Part B premium if you get under $2,494 a month, and savings don’t count. Just you, or a spouse too? And what comes in, before Medicare is taken out?
Just me. 1,640 social security, 410 pension
That’s $2,050, so you qualify. The state would pay all $202.90. The fund’s half stops, so you keep about $101 more a month, plus Extra Help with prescriptions.
I filled in the application. Reply YES and I’ll send it. I’ll handle the renewal every year too.
YES
Sent. I’ll text you as soon as the state confirms it.

The rule.

New York, 2026

Part B premium, every month The 2026 standard premium. CMS.$202.90
A month, one person, before deductions New York’s limit with the $20 disregard. About $3,375 for a couple.~$2,494
Asset test in New York Savings and a home don’t count.None
Eligible people not enrolled MACPAC, 2021–23.4 in 10
WhoWho pays the premium nowWho would payWhat the retiree gets
A retiree under the limit, on a 50% reimbursementHalf the fund, half the retireeThe state, all of itAbout $101 more a month, and Extra Help with prescriptions
A retiree under the limit, on a 100% reimbursementThe plan, all of itThe state, all of itExtra Help with prescriptions. The premium stays covered.
A retiree the state already coversThe state, and the fund againThe state onlyNothing changes
A retiree whose income just dropped, after a spouse’s death or a smaller checkThe fundThe stateThe same as the first row, starting now

Premium: 2026 standard Part B. Limits: New York QI-1, 2026, gross with the $20 disregard. Take-up: MACPAC. Extra Help comes automatically with a Medicare Savings Program.

Your number, grounded in the data.

Three things you already know. The rest comes from New York’s 2026 rules, Census data on New York retirees, and published research on enrollment. Every assumption is listed below, and the free scan replaces it with your own files.

Pension size is the biggest driver. Among New Yorkers 65 and older on Medicare with a pension, about half of those getting under $500 a month are under New York’s limit, and almost none above $2,000.

$28,244What your fund keeps, a year
Retirees likely eligible and not enrolled 148 to 260194
Likely to enroll after your letter and our help 7 to 6529
Premiums New York pays instead of you, a year $8,522 to $79,131$35,305
Our fee, 20% of that$7,061
Back in retirees’ checks, a year$35,305

Each enrolled retiree saves your fund $1,217 a year, every year they stay enrolled. If all 194 enrolled: $236,176 a year. Savings start about 4 months after a retiree says yes, and about 89% stay enrolled each year. We handle the renewals.

How we estimate this
  • Who qualifies: Census Bureau, American Community Survey 2024, New York microdata. We apply New York’s MSP income rules to New Yorkers 65 and older on Medicare and group them by total pension income (every pension combined, so slightly higher than your fund’s alone). The ranges include the survey’s margin of error.
  • Two things the survey misses pull in opposite directions. Surveys under-report pensions a little, which makes our share too high. New York also subtracts health insurance premiums a retiree pays, including union fund premiums, which makes it too low.
  • Already enrolled: about 55% of eligible people are enrolled (range 40% to 65%), from the Urban Institute’s 2021–23 national estimates and MACPAC’s earlier New York estimate. People already enrolled are usually no longer on your reimbursement.
  • Enrolled through outreach: 15% of the people we reach (range 5% to 25%). This is the weakest number. No published trial measures it for the MSP. Mass letters from Social Security added under 1% (GAO, 2004). Letters with help applying reached 18% in a randomized trial for older adults and SNAP (Finkelstein and Notowidigdo, 2019).
  • Timing and renewals: decisions within 45 days and about 3 months for Medicare’s records to update (GAO); 11% to 17% of new enrollees lose coverage within a year (KFF).

After the yes, we keep it working.

The application, filed with her yes

Day 1. In English or Spanish.

The state decides

Weeks. We answer any request for papers.

Your reimbursement stops

Same month. Only once her check stops the deduction, so she never pays twice.

The renewal, sent with her yes

Every year. Before the deadline, so the fund doesn’t start paying again.

What we never do.

Act without a yes.

Nothing is filed, sent or signed until the retiree replies YES to exactly what will happen.

Show the fund a case.

The fund sees totals. It learns a retiree’s name only when that retiree agrees, and only what it needs, like a reimbursement to stop.

Touch anyone’s coverage.

Retirees keep exactly the plan they have. Only who pays the premium changes. We never sell or recommend a Medicare plan.

Charge retirees.

Retirees never pay us. We sign a HIPAA business associate agreement before we see a single file.

Why this isn’t done already.

  • Your rules already ask for it. Plans reimburse Part B when the retiree pays it, not when someone else does. Auditors keep finding plans paying premiums the state or another employer already covers. We make that rule work for every retiree, every month.
  • Only the retiree can apply. No claims system can enroll anyone. The retiree has to confirm their income, agree and sign. We do that with them, from a letter they trust.
  • Every decision is on the record. Each step a retiree takes is logged with what changed, what the system concluded and how sure it was. Your counsel can review any of it.
  • You pay from savings. A share of what you save, for each year a retiree stays enrolled. Nothing for screening, nothing for denials.

Start with one mailing.

Pick the retirees on your Part B reimbursement who likely qualify. You send one letter. We screen, file, follow each case to approval and renew it every year.

A retiree approved for a Medicare Savings Program20% of the premium you no longer pay, each year they stay enrolled
The yearly renewalIncluded
A denial, or no answerNothing
What we report every monthRetirees who answered, and how many qualify; Applications filed, approved and pending; Premium dollars a year off the fund; Renewals sent on time

If nobody is approved, the pilot costs the fund nothing.

Start with a free scan

In 30 days we show you, in dollars, how much of your Part B reimbursement New York would pay, and how many retirees are behind the number.

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